What Is Skin Lightening Cream?

Skin lightening creams, also known as skin brightening creams, are designed to lighten skin color. The creams are often used to spot-treat dark areas of the skin, such as age spots or acne scars. They are sometimes used to lighten the complexion overall.

While these creams can be prescribed for specific skin conditions, they can have side effects. The risks can be serious, especially with over-the-counter creams that may not be tested for safety.

This article discusses how skin lightening creams work. It also covers the conditions they can treat and the risks of using them.

Definition

Skin lightening creams are products designed to bleach and lighten the skin. They target skin cells to decrease the level of melanin. Melanin is a pigment produced by skin cells. It determines how light or dark our skin appears.

Skin lightening products can come in the form of creams, lotions, oils, and serums. Creams and oils are usually heavier and better for dry skin. If your skin tends to be on the oily side, you may want to opt for a lighter serum. Your dermatologist can advise you on which kind is best for your skin type.

Several varieties of skin lightening creams are available online and over the counter (OTC). However, it’s best to talk with your healthcare provider before using skin lightening creams. Prescription products are regularly tested for safety and efficacy, unlike OTC products, which could contain dangerous ingredients. 

How They Work

Skin lightening creams contain ingredients that work to decrease your body’s production of melanin. Melanin is made by cells called melanocytes. Skin bleaching products work by lowering the number of melanocytes in your skin. 

Many skin lightening creams contain hydroquinone, which is known to decrease melanocytes.

Vitamin C, also a common ingredient in skin lightening creams, is an antioxidant that is known to lower melanin production in our cells.

Glycolic acid, which is also found in many skin brightening creams, works as an exfoliant. It helps to brighten the skin by clearing away dead cells. 

Retinoids, products derived from vitamin A, can also be used to lighten dark spots. They work by speeding up the turnover of surface skin cells. They can include retinol, adapalene gel, tazarotene, and tretinoin.

Conditions Treated

Skin lightening creams may be used for various conditions that cause discoloration. These include:

• Age spots
• Freckles
• Acne scars
• Melasma
• Post-inflammatory hyperpigmentation (PIH)
• Hormonal imbalances
• Addison's disease

Melasma and post-inflammatory hyperpigmentation (PIH) are both conditions that cause dark, blotchy areas. Common areas include parts exposed to the sun, like the forehead and cheeks.

PIH leads to a darker complexion in areas inflamed because of injury to the skin. For example, scarring may cause darker areas, or severe acne can leave dark spots after it resolves.

Hormonal imbalances and endocrine conditions like Addison's disease can also lead to darkening of the skin. 

With Addison's disease, the adrenal gland doesn't produce enough of certain hormones. Those with Addison's disease produce a high level of adrenocorticotropic hormone, which stimulates the melanocytes to produce more melanin, resulting in skin darkening.

Warnings

In 2020, OTC products containing hydroquinone were removed from the market. This was because the Food and Drug Administration (FDA) classified them as "not generally recognized as safe and effective." Even though hydroquinone products were removed from store shelves, they're still available by prescription.

The ingredient hydroquinone has been linked to exogenous ochronosis, a disorder that makes the skin appear black and blue. This condition is difficult to treat and can result in permanent discoloration of the skin. It may be more common when applying hydroquinone over a large area of the skin or in higher concentrations.

Because many skin lightening creams contain corticosteroids, steroid acne is also a possible side effect. It can also lead to skin breakdown and leave users with open sores and scarring.

Milder side effects have also been reported, including dermatitis and skin irritation.

Risks of Mercury Poisoning

Concerns have been raised over recent years about the mercury content in some skin lightening creams.

Mercury is a heavy metal that is toxic in even small amounts. The FDA has limited the amount of mercury in cosmetic products to trace amounts not exceeding 1 part per million (ppm).

However, in a 2014 study, researchers tested 549 skin lightening products for their mercury content. They found that 6% contained mercury levels above 1,000 ppm, while some had mercury levels as high as 10,000 ppm. Of the U.S. products, 3.3% had mercury levels over 1,000 ppm.

Though products from the United States were somewhat safer, it can be difficult to determine the country of origin of products purchased online. 

Being exposed to mercury over time can cause symptoms like:

• Numbness
• Tingling
• Dizziness
• Forgetfulness
• Headaches
• Depression

More severe symptoms include:

• Confusion
• Muscle weakness
• Trouble breathing
• Changes in vision
• Difficulty walking

Mercury poisoning requires immediate medical attention.

Exposure to mercury can also cause kidney damage over time. Users of skin brightening products have been diagnosed with nephrotic syndrome after using the cream for months. Nephrotic syndrome is a kidney disorder that causes the body to excrete too much protein in the urine.

Symptoms of nephrotic syndrome include:

• Severe swelling
• Fluid retention
• Foamy urine
• Fatigue
• Loss of appetite

Nephrotic syndrome is treatable, however, and will resolve once the mercury exposure stops.

More research is needed to determine the long-term effects of using skin-lightening products. The chemicals in skin lightening creams have not been studied over a long period of time, so it's unknown if they will lead to long-term conditions. 

Summary

Skin lightening creams may be used to spot-treat dark areas of the skin or lighten skin overall. They may be prescribed for specific skin conditions, such as melasma and post-inflammatory hyperpigmentation.

However, these creams can have serious side effects. Those with hydroquinone can cause a disorder called exogenous ochronosis, which causes the skin to become black and blue. Some skin lightening creams may contain mercury, which can lead to mercury poisoning or a kidney disorder called nephrotic syndrome.

A Word From Verywell

When used with a healthcare provider's supervision, skin lightening creams can be an option to help with any unwanted skin darkening or spots. But be realistic about how effective these products can be in brightening skin tone or reducing the appearance of dark spots.

Always talk with your healthcare provider before using any skin lightening products. They can make sure you're using a cream that's safe for you and appropriate for your skin condition.